Author/Editor		Mayer, Ramona; Prettenhofer, Ulrike; Quehenberger, Franz; Guss, Helmut; Hackl, Arnulf
Title		Ependymomas in adult patients: results of adjuvant radiotherapy
Translated title		Ependimom pri odraslih bolnikih: rezultati zdravljenja z adjuvantno radioterapijo
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 34, št. 3
Publication year		2000
Volume		str. 295-300, 314
Language		eng
Abstract		Background. As ependymomas are rare tumours and experiences base on the results of retrospective: studies, we assess the survival and pattern of recurrence in eight adult patients with intracranial or spinal ependymoma who were treated with adjuvant radiotherapy. Patients and methods. The data of a series of adult patients with low/intermediate (7) or high-grade (1) ependymomas receiving postoperative radiotherapy are presented. Between 1985 and 1994, eight patients (mean age 41 years, range 18-55 years) with intracranial (2) or spinal (6) ependymoma were irradiated either after macroscopically complete surgery (4), or incomplete surgery (1) or for salvage after incomplete resection of local recurrence (3). Radiotherapy with a mean dose of 52 Gy (range, 50-54Gy) was given to generous local fields with boost, not to the entire craniospinal axis. Results. Median follow-up was 101 months (range, 12-146 months); the 5-year overall survival and disease-free survival were 100 % and 8z %, respectively. Infield failure occurred in one patient with intracranial and one with spinal ependymoma 77 months after radiotherapy in both cases. Initially, these two patients had been irradiated after incomplete resection of a recurrent tumour Two patients with spinal cord tumours showed outfield failure in the spinal cord 38 and 86 months after radiotherapy. No irradiation induced late effects were observed. Conclusions. Adjuvant radiotherapy after incomplete surgery and/or local recurrence and/or high-grade tumours seems to be efficient to prolong local control in this rare disease.
Summary		Izhodišča. Ependimom je zelo redek tumor. Ker izkušnje o zdravljenju temeljijo predvsem na retrospektivnih študjah, smo tudi mi preživetje in ponovitev bolezni proučevali na osmih odraslih bolnikih z ependimomom v lobanji ali na hrbtenici, ki smo jih predhodno zdravili z adjuvantno radioterapijo. Bolniki in metode. V študiji smo predstavili 7 bolnikov z ependimomom z nizko in srednjo stopnjo in 1 bolnika z visokostopenjskim ependimomom. Vsi so bili po operaciji zdravljeni še z radioterapijo. Od 8 bolnikov s povprečno starostjo 41 let (18-55 let), ki so bili zdravljeni od 1985 do 1994, sta 2 bolnika imela ependimom v lobanji, 6 pa na hrbtenici. Pri 4 bolnikih je bil ependimom makroskopsko popolnoma odstranjen, pri 1 je bil delno odstranjen, pri 3 pa je bil potreben dodatni kirurški poseg po nepopolni odstranitvi lokalno ponovljene bolezni. Obsevalno polje ni obsegalo celotne kraniospinalne osi. Povprečni obsevalni odmerek je bil skupno z dodatnom obsevanjem 52 Gy (50-54 Gy). Rezultati. Povprečni čas sledenja bolnikov je bi 101 mesec (12-146 mesecev), petletno preživetje je bilo 100 %, preživetje brez znakov bolezni pa 86%. Recidiv znotraj obsevalnega polja smo zasledili 77 mesecev po radioterapiji pri 1 bolniku z ependimomom v lobanji in pri 1 bolniku z ependimomom na hrbtenici. Oba bolnika smo obsevali po delni odstranitvi ponovno zraslega tumorja. Recidiv zunaj obsevalnega polja pa smo opazili pri 2 bolnikih s tumorjem na hrbtenici in sicer pri prvem 38 mesecev po zaključenem obsevanju, pri drugem pa po 86 mesecih. Pri nobenem bolniku nismo zasledili kasnejsih stranskih učinkov obsevanja. Zaključek. Adjuvantna radioterapija se zdi učinkovita za ohranitev lokalnega nadzora te precej redke bolezni predvsem pri bolnikih, kjer smo samo delno odstranili tumor, ali pri tistih, kjer je prišlo do ponovitve bolezni ali pa je bil tumor visoke malignostne stopnje.
Descriptors		EPENDYMOMA ADULT MIDDLE AGE RADIOTHERAPY, ADJUVANT NEOPLASM STAGING SURVIVAL ANALYSIS RETROSPECTIVE STUDIES